Everyone’s on Ozempic. So why will no one talk about it?

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One of the most notable developments at fashion month? There’s been a lot more space available, for a start. The benches have seemed roomier. And it’s not for a lack of people at the circus, it’s just that many of those people are now half the size. In the wake of widespread availability of weight-loss drugs for more than a year now, we are beginning to see the true scale of the Ozempic effect.

That Ozempic (or Wegovy, the name by which the weight-loss version of the drug semaglutide is marketed) should have proliferated in an industry that has always venerated thinness will hardly come as a surprise. Nevertheless, it’s stunning to see colleagues suddenly transform into the incredible shrinking woman — or man.

What I find curious about this new wave of waifs is how coy they are about talking about the drug. I’ve lost count of the number of newly emaciated editors and stylists extolling their current diet and brand new fitness regimens. I spent several minutes the other day discussing one editor’s weight-loss journey — he had shed some 20kg since the winter, simply, he insisted, by taking his diet in hand. He told others that he had been using weight-loss injections, which suggests he felt a stigma associated with the drug. And he might be right. Another editor railed against Ozempic “cheaters” who simply shrug off the extra kilos without using the traditional tools of denial, willpower and hunger pains.

Ozempic and Wegovy are now major tools in the fight against obesity. Their maker, the Danish pharmaceutical company Novo Nordisk, now has a market capitalisation of around $560bn: Ozempic alone made up 27 per cent of its net sales in its 2023 financial year. (No wonder other manufacturers, such as Eli Lilly, are keen to grab some market share.) The costs, currently the subject of a debate raised this week by Senator Bernie Sanders, who is chair of the US Senate health committee, have become a source of ire: Americans pay around $969 a month for their Ozempic, whereas Germans pay only $59. And demand is insatiable. Forty per cent of American adults are currently categorised as obese, a number that has dropped, according to a report by the Centre for Disease Control, by 2 per cent in the past three years. It’s too soon to say whether this is due to the increasing use of the weight-loss drug, but it does show a reversal in a trend for the first time since records began.

Right now, there is a global shortage of the drug: pity the poor diabetics for whom it was initially designed. And because of widespread uptake and patchy distribution, few definitive studies have been able to ascertain its long-term effects. Some suggested that most users will regain two-thirds of the weight they lost within a year of stopping, and others that it gives some people indigestion and diarrhoea. When I talked this week to Dr Nathan Curran, a longevity specialist at London’s upscale private Mayfair Galen Clinic, he noted that most of his clients on Ozempic expect to take a small dose for the rest of their lives. The only downside he had noticed was that, unless patients made significant lifestyle changes in accordance with the rapid weight loss, they would have a lot of wasted muscle or “skinny fat” to deal with, and that their weight loss would likely plateau within two years.

For many people, semaglutide is now a way of life. And the benefits far outweigh the risks. In another study reported on this week in the Guardian, the healthcare costs and productivity losses from the global obesity crisis far outstrip the cost of the weight-loss drugs.

Despite that, most of the people I know who are using would in no way be termed obese. Instead, they are simply using the drug to look “catwalk thin”. And hey. No judgment. I totally understand that someone who has spent a career in a business that loathes fat might want to join the wraithlike club. That so few of them want to discuss their drug use just goes to show how pervasive sizeism remains. Culturally, we are still dismissive of anyone who has simply shrugged off weight without having the “do the work”.

Even Lizzo, the outsize singer once considered an icon of body inclusivity and self-love, has started posting pictures of, or should that be in the parlance of tabloid journalism, “flaunting” her newly diminished figure on social media. Her appearance, she says, is the product of hard work, clean living and regular skipping-rope sessions at the gym. She says she hasn’t used weight-loss drugs to achieve her slimmer size, but the media is desperate for her to “admit” that she’s indulged.

Why should she be “admitting” to anything? Why does my slimmed-down front-row friend feel the need to deny his Ozempic use? Why is the language of weight loss still so deeply coded in moral judgments and the unshakeable belief in the “deserving thin”? Slimmer people, goes the narrative, are stronger, sharper and more disciplined. Fat people are deemed lazy and lacking in will. Ozempic has only compounded those prejudices — it’s still a game of us and them. And it seems to me a weird bias that insists that being fat is a personality trait that one must carry long after the weight is gone.

It’s especially painful considering that, until very recently, fashion was dealing with a reckoning in which we demanded to see more body diversity. At most shows this month, the catwalks have featured one single “outsize” model, forced to walk, like some totem of our tolerance, among a phalanx of rail-thin girls. Fashion inclusivism, once a subject in the ascendant, has been squashed back to low priority: fat is fine in fashion, it seems, so long as that fat person is someone other than oneself.

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